Senior Insurance Associate
MetLife
- Jaipur, Rajasthan
- Permanent
- Full-time
- To manage dental business procedures of Dental claims in partnership with stateside
- This role will document new or revise guidelines for process, procedures and initiatives to support dental claim operations in all areas of claim management.
- Documents all standard and non-standard Dental process guidelines and correspondence within the Group Dental Product. Able to document business requirements into efficient process steps and actions for the development of guidelines.
- Assist with the management, processing and documentation of customer variances from a process and correspondence perspective.
- Ensure that requested updates are handled timely and accurately and meeting our customer needs while remaining within all compliance and regulatory requirements.
- Review, investigate and respond to questions related to individual change requests. Identify gaps in content and/or inefficiencies in proposed process and recommend alternative solutions.
- Work with multiple partners for investigation, analysis, and development of nonstandard process and/or correspondence requests including but not limited to claim operations, customer delivery and legal. Works with all parties to ensure agreement and sign off on final outcome.
- May communicate information to requestors and other business partners to help resolve inquiries related to a requested change for process and/or correspondence.
- Performs other duties as assigned or required
- Unit Manager / Manager for the purpose of reporting performance, escalation handling, clarifying concerns, and seeking feedback and support.
- Unit Manager / Manager for the purpose of settling issues left unresolved and monthly evaluation of performance.
- Stateside Auditors for the purpose of seeking cooperation & clarification on process-related matters & providing assistance and support when required.
- Subject Matter Expert for the purpose of work thread related issues and escalated transactions.
- Trainers for the purpose of Pre-process and Process training.
- Stateside process owner for business discussion.
- 3-5 years of Group Life or Group Dental claims management experience. Expert knowledge/experience level of varied process/products, Federal and State regulations, claim management and correspondence systems.
- Excellent verbal & written communication skills/ content writing skills
- Highly organized; able to work independently and prioritize work to meet changing business needs, timelines, goals and metrics.
- Demonstrated leadership skills and self-direction a must.
- Demonstrated ability to manage multiple, completing priorities.
- Able to work with various company databases (SharePoint, Livelink), Webex and Microsoft program suite (Word, Excel).
- Bachelor’s degree (Any Stream) or diploma with a minimum of 15 years of education.
- Excellent verbal & written communication skills
- Proficient in usage of MS Office suite
- Good computer navigation skills
- Good keyboarding speed
- Excellent knowledge of complete Ms Office suite
- Knowledge about the Insurance industry in US
- Knowledge about US Culture
- Knowledge of Insurance principles.
- End to end product knowledge on Dental required
- Proficiency in English language both written & verbal skills
- Excellent Communication skills – should be able to read, interpret business documents.
- Analytical and interpersonal skills
- Data gathering ability/ Eye for detail
- Team work/ Managing Self / Adaptability
- Highly organized with ability to work independently
- Prioritize work to meet changing business needs, timelines, goals and metrics. (Project management skills)
- Adaptability to change
- Self disciplined and result oriented
- Ability to multi task
- Familiarity with Dental Terminology
- Bachelor’s degree (Any Stream) or diploma with a minimum of 15 years of education.(Candidates with B.Tech, MBA, BCA, or with any technical education would not be required)